Your physician has determined that colonoscopy is necessary for further evaluation or treatment of your condition. This document will help you understand the procedure. It answers a few most frequently asked questions. Please read it carefully. If you have additional questions, please feel free to discuss them with the Endoscopy nurse or your physician before the examination begins.
What is a colonoscopy?
Colonoscopy is a procedure in which your physician examines the colon lining, (large bowel), for abnormalities. This is done by inserting a flexible tube approximately as thick as your finger into the anus and advancing it slowly into the rectum and colon.
What preparation is required?
The colon must be completely clean for the procedure to be accurate and complete. Your physician will give you detailed dietary instructions and restrictions, and address the cleansing routine to be used. During the preparation, you generally consume a large volume of a special cleansing solution or several days of clear liquids, laxatives, and enemas prior to the examination. Follow your doctor’s instructions carefully. If you do not, the procedure may have to be rescheduled.
What about my current medications?
Most medications may be continued as usual, but some can interfere with the preparation or the examination. Inform your physician of you current medications, and any allergies to medications several days prior to your visit. Aspirin products, arthritis medicines, anticoagulants (blood thinners), insulin, and iron products are examples. Inform your doctor if you require antibiotics prior to undergoing dental procedures, because you may need antibiotics prior to colonoscopy as well.
What can be expected during colonoscopy?
Colonoscopy is usually well tolerated and rarely causes much pain. There is often a feeling of pressure, bloating, or cramping at times during the procedure. Your doctor may medicate you through a vein to help you relax and tolerate procedural discomfort. You will be lying on your side or back while the colonoscope is advanced slowly through the large intestine. As the colonoscope is slowly withdrawn, the lining is again carefully examined. The procedure takes 15 to 60 minutes. In some cases, passage of the colonoscope through the entire colon to its junction with the small intestine can not be achieved. The physician will decide if the limited exam is sufficient or if others are necessary.
What if the colonoscopy show something abnormal?
If your doctor thinks an area of the bowel needs to be evaluated in greater detail, a forceps instrument is passed through the colonoscope in order to obtain a biopsy (sample of the colon lining). This specimen is submitted to the pathology laboratory for analysis. If colonoscopy is used to identify bleeding sites, these are controlled through certain medications or a coagulation (sealing off bleeding vessels with heat treatment). If polyps are found, they are generally removed. None of these additional procedures typically produces pain. Remember, the biopsies are taken for many reasons and do not indicate that cancer is suspected.
What are polyps and why are they removed?
Polyps are abnormal growths from the lining of the colon that vary in size from a tiny dot too several inches. The majority of polyps are benign (non-cancerous) but the doctor can not always tell a benign polyp from a malignant (cancerous) polyp by its outer appearance alone. For this reason, removed polyps are sent for tissue analysis. Removal of colon polyps is an important means of preventing colorectal cancer.
How are polyps removed?
Tiny polyps may be totally destroyed by fulguration (burning), but rather larger polyps are removed by a technique called snare polypectomy. The doctor passes a wire loop (snare) through the colonoscope and severs the attachment of the polyp from the intestinal wall by means of an electrical current. You should feel no pain during the polypectomy. There is a small risk that removing a polyp will cause bleeding or result in a burn to the wall of the colon, which could require emergency surgery.
What happens after a colonoscopy?
After a colonoscopy, your physician will explain the results to you. If you have been given medications during the procedure, someone must accompany you home from the procedure because of the sedation used during the examination. Even if you feel alert after the procedure, your judgment and reflexes may be impaired by the sedation for the rest of the day, making it unsafe for you to drive or operate any machinery.
You may have some cramping or bloating because of the air that is introduced into the colon during the examination. This should disappear quickly with the passage of flatus (gas). Generally, you should be able to eat after leaving the endoscopy, but your doctor may restrict your diet and activities, especially after a polypectomy.
What are the possible implications of a colonoscopy?
Colonoscopy and polypectomy are generally safe when performed by physicians who have been specially trained and are experienced in these endoscopic procedures.
One possible complication is perforation or tears through the bowel wall that could require surgery. Bleeding may occur from the site of biopsy or polypectomy. It is usually minor and stops on its own or can be controlled through the colonoscope. Rarely, blood transfusions or surgery is required. Other potential risks include a reaction to the sedatives used and complications from heart or lung disease. Localized irritation of the vein where medications were injected may rarely cause a tender lump lasting for several weeks, but this will go away eventually. Applying hot packs or hot moist towels may help relieve the discomfort.
Although complications after a colonoscopy are uncommon, it is important for you to recognize early signs of any possible complication. Contact your physician who performed the colonoscopy if you notice any of the following symptoms: severe abdominal pain, fever and chills, or rectal bleeding of more than one-half cup. Bleeding can occur several days after the polypectomy.
To the patient
Because education is an important part of the comprehensive medical care, you have been provided with this information to prepare you for this procedure. If you have questions about your need for the colonoscopy, alternative tests, the cost of the procedure, methods of billing, or insurance coverage, do not hesitate to speak to your doctor or your doctor’s office staff. Most endoscopists are highly trained specialist and welcome your questions regarding their credentials and training. If you have any questions that have not been answered, please discuss them with the endoscopic nurse or your physician before the examination begins.
Greenbelt Endoscopy Center
9821 Greenbelt Road
Lanham, MD 20706